An evaluation of the proposed DSM-5 alcohol use disorder criteria using Australian national data
Article first published online: 7 MAR 2011
© 2011 The Authors, Addiction © 2011 Society for the Study of Addiction
Volume 106, Issue 5, pages 941–950, May 2011
How to Cite
Mewton, L., Slade, T., McBride, O., Grove, R. and Teesson, M. (2011), An evaluation of the proposed DSM-5 alcohol use disorder criteria using Australian national data. Addiction, 106: 941–950. doi: 10.1111/j.1360-0443.2010.03340.x
- Issue published online: 8 APR 2011
- Article first published online: 7 MAR 2011
- Accepted manuscript online: 16 DEC 2010 08:01AM EST
- Submitted 17 August 2010; initial review completed 8 October 2010; final version accepted 1 December 2010
- Alcohol use disorder;
- differential criterion functioning;
- DSM-5 criteria;
- DSM-IV criteria;
- item response theory
Aims To evaluate the proposed revisions to the DSM-IV alcohol use disorder criteria using epidemiological data.
Design, setting and participants Data came from the 1997 Australian National Survey of Mental Health and Well-Being. The sample consisted of 10 641 participants aged 18 years and over.
Measurements Alcohol use disorders were assessed using a revised version of the CIDI version 2.0. Alcohol use disorders were assessed in all respondents who indicated that they had used alcohol more than 12 times in the previous 12 months (n = 7746).
Findings The proposed introduction of a single alcohol use disorder was supported by confirmatory factor analysis (CFA). DSM-5 criteria were all indicators of a single underlying disorder. Under DSM-5, the prevalence of alcohol use disorders would increase by 61.7% when compared with those diagnosed under DSM-IV. When investigating the most appropriate diagnostic threshold, the 3+ threshold maximized agreement between DSM-IV and DSM-5 diagnoses, and produced similar prevalence estimates to those yielded by DSM-IV. Item response theory (IRT) analyses supported the removal of the legal criterion while provided equivocal results for the craving criterion.
Conclusions Under the proposed DSM-IV revisions for alcohol use disorders, estimates of the prevalence in the general population would increase substantially. Whereas evidence supports some of the revisions such as a single underlying disorder, others such as the 2+ threshold for diagnosis of alcohol use disorder and the inclusion of a ‘craving’ criterion may be problematic.